Center for Men'S Health - Brandon

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

ME39549 Issued in FL

Legal business name

CENTER FOR MEN'S HEALTH - BRANDON

Practice address

1109 Professional Park Dr
Brandon, FL 33511-4887

Phone

(813) 409-2042

Fax

(813) 409-2044

NPI assigned

Mar 20, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Paul A Sloan

Title

Group Administrator

Phone

(941) 349-6583

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336521600000",
    "number": "1679848907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 PROFESSIONAL PARK DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114887",
            "telephone_number": "813-409-2042",
            "fax_number": "813-409-2044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 PROFESSIONAL PARK DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114887",
            "telephone_number": "813-409-2042",
            "fax_number": "813-409-2044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR MEN'S HEALTH - BRANDON",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-20",
        "last_updated": "2012-05-09",
        "status": "A",
        "authorized_official_last_name": "SLOAN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "GROUP ADMINISTRATOR",
        "authorized_official_telephone_number": "941-349-6583",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "FL",
            "license": "ME39549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Brandon, FL
• Providers in Brandon, FL by specialty
• Medical Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.